本文關(guān)鍵詞： 睡眠呼吸暫停 島葉皮層 電刺激 頦舌肌 膈肌 高頻電深部腦刺激　出處：《吉林大學(xué)》2012年碩士論文　論文類型：學(xué)位論文

【摘要】：睡眠呼吸暫停綜合征，又稱睡眠呼吸暫停低通氣綜合癥是指每晚7小時(shí)睡眠過程中呼吸暫停反復(fù)發(fā)作30次以上或者睡眠呼吸暫停低通氣指數(shù)（AHI）≥5次/小時(shí)并伴有嗜睡等臨床癥狀。行多導(dǎo)睡眠圖儀（PSG）監(jiān)測可明確診斷。根據(jù)發(fā)病機(jī)制分為三類，其中阻塞性睡眠呼吸暫停綜合征占大多數(shù)。患阻塞性睡眠呼吸暫停綜合征(OSA)時(shí)，由于反復(fù)發(fā)作的低血氧、高碳酸血癥可致神經(jīng)功能失調(diào)，兒茶酚胺、內(nèi)皮素及腎素-血管緊張素系統(tǒng)失調(diào)，內(nèi)分泌功能紊亂及血液動(dòng)力學(xué)改變，造成全身多器官多系統(tǒng)損害，嚴(yán)重影響人體健康。我國多個(gè)地區(qū)對(duì)該疾病的流行病學(xué)調(diào)查顯示人群發(fā)病率為4%左右，且男性高于女性。由于生活水平的提高及人們生活習(xí)慣的改變，該疾病的發(fā)病率呈上升趨勢，因此對(duì)該疾病發(fā)病的中樞機(jī)制及可能的治療方法的研究刻不容緩。 目的：探討電刺激島葉皮層對(duì)大鼠呼吸運(yùn)動(dòng)的影響，從而對(duì)OSA發(fā)病機(jī)制的進(jìn)一步研究提供理論依據(jù)。 方法：將65只大鼠隨機(jī)分為三組：電刺激島葉組：實(shí)驗(yàn)組15只，對(duì)照組10只；電刺激韁核組：實(shí)驗(yàn)組10只，對(duì)照組10只；高頻電刺激阻斷韁核后電刺激島葉組20只。首先應(yīng)用同心圓電極刺激島葉皮層、韁核，同時(shí)記錄大鼠呼吸曲線、頦舌肌及膈肌肌電活動(dòng)，每次連續(xù)描記1小時(shí)。電刺激島葉出現(xiàn)呼吸暫停確定位置后，立即高頻電（200Hz,0.08-0.1mA，0.3ms）刺激韁核30min，然后刺激島葉皮層，同時(shí)記錄大鼠呼吸曲線、頦舌肌及膈肌肌電活動(dòng)。應(yīng)用SPSS13.0統(tǒng)計(jì)軟件對(duì)所得數(shù)據(jù)采用配對(duì)樣本t檢驗(yàn)，P0.05為差異有顯著性意義。實(shí)驗(yàn)數(shù)據(jù)以均數(shù)±標(biāo)準(zhǔn)差表示，數(shù)據(jù)應(yīng)符合正態(tài)分布。 1、電刺激島葉組：由于大鼠出血、麻醉等原因死亡。因此記錄Wistar大鼠21只刺激前后呼吸曲線及頦舌肌、膈肌肌電。其中實(shí)驗(yàn)組12例，刺激后大鼠出現(xiàn)明顯的呼吸暫停及不同程度的呼吸紊亂。呼吸頻率較刺激前加快，呼吸幅度較刺激前加大。刺激前后二者變化差異具有顯著意義。頦舌肌肌電活動(dòng)受到明顯抑制，表現(xiàn)為頦舌肌放電減少甚至消失，與刺激前相比，肌電幅度降低，并延續(xù)到刺激停止后一段時(shí)間才恢復(fù)到刺激前水平。同時(shí)膈肌肌電活動(dòng)明顯增強(qiáng)，表現(xiàn)為肌電幅度明顯升高，并延續(xù)到刺激停止后一段時(shí)間才恢復(fù)刺激前水平。對(duì)照組大鼠9只，未出現(xiàn)呼吸暫停及呼吸紊亂，刺激前后呼吸頻率和呼吸幅度無顯著差異，頦舌肌及膈肌肌電無顯著差異。 2、電刺激韁核組：電刺激韁核后，大鼠出現(xiàn)明顯的呼吸暫停及呼吸紊亂，頦舌肌肌電受到明顯抑制，表現(xiàn)為頦舌肌放電減少甚至消失，與刺激前相比，肌電幅度降低，并延續(xù)到刺激停止后一段時(shí)間才恢復(fù)到刺激前水平。同時(shí)膈肌肌電活動(dòng)明顯增強(qiáng)，，表現(xiàn)為肌電幅度明顯升高，并延續(xù)到刺激停止后一段時(shí)間才恢復(fù)刺激前水平。 3、應(yīng)用200Hz高頻電刺激韁核不能引起大鼠呼吸暫停，在高頻電刺激韁核30min后電刺激島葉皮層，大鼠呼吸紊亂程度較未高頻電刺激韁核前程度減輕。 結(jié)論：1、電刺激島葉皮層可引起大鼠不同程度的呼吸暫停、呼吸紊亂及頦舌肌、膈肌肌電活動(dòng)的改變。2、電刺激韁核可引起大鼠不同程度的呼吸暫停、呼吸紊亂及頦舌肌、膈肌肌電活動(dòng)的改變。3、不同頻率電刺激對(duì)大鼠呼吸運(yùn)動(dòng)影響不同，高頻電刺激可能阻斷韁核，從而阻斷島葉皮層信號(hào)傳導(dǎo)。
[Abstract]:Sleep apnea syndrome, also known as sleep apnea hypopnea syndrome refers to 7 hours per night during sleep apnea repeated more than 30 times or sleep apnea hypopnea index (AHI) is more than 5 times per hour and accompanied by lethargy and other symptoms. For polysomnography (PSG) monitoring can make a definite diagnosis. According to the pathogenesis. Divided into three categories, including obstructive sleep apnea syndrome. The majority of patients with obstructive sleep apnea syndrome (OSA), due to repeated episodes of hypoxemia, hypercapnia can cause neurological disorders, catecholamines, endothelin and renin-angiotensin system disorders, change endocrine disorders and systemic hemodynamics, causing multiple organ damage, seriously affect human health. In many areas of China on the epidemiological investigation of the disease showed that incidence rate is about 4%, and higher than the male Women, because of the improvement of living standard and the change of people's living habits, the incidence of this disease is on the rise. Therefore, it is urgent to study the central mechanism and possible treatment of the disease.
Objective: To explore the effects of electrical stimulation of the insula on the respiratory movement in rats, and to provide a theoretical basis for further research on the pathogenesis of OSA.
Methods: 65 rats were randomly divided into three groups: electrical stimulation of insular group: experimental group 15, control group 10; electrical stimulation of habenular nucleus group: experimental group 10, control group 10; high frequency electrical stimulation of habenular nucleus after blocking electrical stimulation of insular group 20. The first to stimulate insular application of concentric electrode cortex, habenula, simultaneous recording of breathing curve of rats, genioglossus and phrenic muscle activities, each successive record 1 hours. Electrical stimulation of the insula appear apnea is located, immediate high frequency electric (200Hz, 0.08-0.1mA, 0.3ms) 30min stimulation of habenular nucleus, then stimulate the insular cortex. At the same time to record the breath curve of rats, genioglossus and phrenic muscle activities. The application of SPSS13.0 statistical software for data obtained using the paired samples t test, P0.05 had significant difference. The experimental data with the mean standard deviation of that data should be consistent with the normal distribution.
1, electrical stimulation of insular group: rats due to bleeding, death and other reasons. Therefore, recorded before and after anesthesia 21 Wistar rats stimulated respiration curve and genioglossus and diaphragm EMG. Among the 12 cases in the experimental group, after stimulation appears significantly different degree of apnea and breathing disorders, respiratory rate is. Before stimulation accelerated, respiratory amplitude is before stimulation increased. There was significant difference between the two changes before and after stimulation. The genioglossus EMG activity was inhibited and the performance of genioglossus muscle discharge decreased or even disappeared, compared with before stimulation, the EMG amplitude decreased, and continues to stimulate a period of time to stop after recovery to pre stimulus at the same time. The level of diaphragmatic EMG activity increased, as the EMG amplitude was significantly increased, and continues to be a period of time after cessation of stimulation was restored to the level before stimulation. The control group of 9 rats without apnea and respiratory disorders, respiratory frequency before and after stimulation There was no significant difference in rate and amplitude of respiration, but no significant difference between genitocutaneous and diaphragmatic myoelectromyography.
2, electrical stimulation of the habenular nucleus group: electrical stimulation of habenular nucleus after rats appear obvious apnea and respiratory disorders, genioglossus muscle activity was inhibited and the performance of genioglossus muscle discharge decreased or even disappeared, compared with before stimulation, the EMG amplitude decreased, and continues to be a period of time after cessation of stimulation did not recover to the level before stimulation. At the same time the diaphragmatic EMG activity increased, as the EMG amplitude was significantly increased, and continues to be a period of time after cessation of stimulation was restored to the level before stimulation.
3, 200Hz high frequency electrical stimulation of habenular nucleus can not cause apnea in rats. After stimulation of habenular nucleus 30min after high frequency electrical stimulation, the degree of respiratory disturbance in rats is reduced compared with that before high frequency electrical stimulation of habenular nucleus.
Conclusion: 1, electrical stimulation of insular cortex can cause different degree rat respiratory pause, respiratory disturbance and genioglossus and diaphragm EMG activity changes of.2, electrical stimulation of habenular nucleus can cause different degree rat respiratory pause, respiratory disturbance and genioglossus and diaphragm EMG activity changes of.3, different the frequency effect of electric stimulation on the respiratory movement of rats, high frequency stimulation may block the habenular nucleus, thereby blocking the signal transduction in the insular cortex.

【學(xué)位授予單位】：吉林大學(xué)
【學(xué)位級(jí)別】：碩士
【學(xué)位授予年份】：2012
【分類號(hào)】：R766

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